Practice Management News

A publication of...

Helpful Forums
PTManager
Rehab Edge
ADVANCE PT Talk Forum
MyPhysicalTherapySpace
Acute PT

Follow SpectraSoft . . .

About PMN
Practice Management News is a free newsletter for SpectraSoft customers and friends, offering insightful articles, handy user tips and troubleshooting advice to help you get more done with SpectraSoft software.

The Annals of Family Medicine (AFM) has published several studies on the problem of no-shows. Here's a look at one of those studies along with five steps to reduce your no-shows with scheduling methods, innovative appointment reminder methods and patient tracking.

White Paper: 8 Steps to Reduce No-Shows

For more tip on reducing no-shows, download our FREE white paper...

Step 1: Educate the Patient

Two-thirds (65%) of no-show patients in the AFM study mentioned that negative emotions about going to the appointment were greater than the perceived benefit of keeping the appointment. Likewise, self-resolving symptoms resulted in missed appointments.

One patient explained, "When my feet were swollen it was on my mind, but as soon as the swelling went down, then I forgot about it." The AFM study also cites previous research which suggests that people with a history of failed appointments are less likely to understand the purpose of the appointment.

All of these factors suggest that it is very important to help your patients understand WHY it is important to keep the appointment. Two examples:

The treatment may hurt for a while, but the benefits will last for a lifetime
Even if the symptoms go away for a while, the underlying problem must still be treated.

It's critical that practitioners explain these rationales to patients. If your patient has a history of no-shows, add a pop-up note in your scheduling software (in AppointmentsPRO click Data > Patient > Notes) reminding the practitioner to emphasize these points during the visit.

You should also Incorporate this language into the appointment reminder letter you give the patient when the next visit is scheduled (in AppointmentsPRO click Data > Patient Reminder). You should also add this language to the script of your phone reminders and to the text of your email reminders.

Step 2: Limit Wait Times
Issues of respect were a factor in no-shows among 44% of the AFM study participants. Waiting was one way disrespect was communicated: not only the time in the waiting room, but also in the exam room. Wait times have a great impact on patient satisfaction, and in turn on physician referrals and other sources of new business.

Track average patient wait times -- and work with your staff to limit the average wait to no more than five minutes (in AppointmentsPRO: Reports > Statistical Reports > Arrived vs Seen Comparison).
Use an auto-notification system -- that alerts practitioners when a patient arrives. (AppointmentsPRO can send automated alerts to the practitioner's laptop or by text message.)

Some patients also felt the health care staff did not respect their history. A practice-wide, standardized documentation system allows one practitioner to step in for another when necessary and get up to speed on the patient's condition very quickly.

Step 3: Be Available
Both the AFM study and previous research found that no-show rates increase as the time grows between the scheduling date and the actual appointment. Hold times throughout your week specifically for new patients, so that you can get them in right away.

It's always difficult to leave open slots that may never be filled, but if new patients cannot get in to see you for several days, consider the negative impact this will have not only on your no-show rate, but also on your ability to get and keep new patients.

Step 4: Put the Needs of the Patient First
Logistical issues such as trouble getting off work, child care, transportation, and cost were also cited as factors in the study. There are several things you can do to reduce these types of cancellations.

1. Use open-ended questions when scheduling patients. Many people can be forgetful or distracted when scheduyling an appointment on their way out of the office. Instead of giving them a time and asking if they can make it, involve them in the scheduling process with an open-ended question:

Wrong: “How is Monday morning at 10?”
Right: “What day is good for you?

2. Automate the appointment-finding process. If your practice is busy, open times are scarce and you have to awkwardly flip through a book to find available times, a patient may eventually settle for less than the best possible appointment. Use computer scheduling logic to enter the requirements of the appointment and find the best time for both you and your patient. (In AppointmentsPRO click Appointment > Find Appointment).

3. Track common causes of no-shows. If your scheduler is aware of the most common reasons for no-shows, you can proactively resolve them. For instance, if an appointment is made at roughly time the school lets out, the scheduler can ask, "Do you have children you need to pick up?"

You will need a scheduling system to track the causes of no-shows and report the stated reasons. (In AppointmentsPRO: (Reports > Statistical Reports > Cancellation Summary and Reports > Statistical Reports > No-Show Summary).

Step 4: Enhance Your Reminder Program
Simply forgetting the appointment was another cause of no-shows. In today's cluttered, hectic times, no one reminder method works well. That’s why a “multi-touch” reminder system is important. It should include:

For tips on how to format the content of each of these reminders, request the PMN white paper: 8 Steps to Reduce No-Shows & Cancellations.

Step 5: Communicate the Negative
Forty-one percent of the participants indicated they did not know what happens in a clinic if there is a failed appointment. Many believed that canceled appointments occur regularly and allow the practitioners to catch up or take a break.

Your reminder messages should stress the importance of the appointment. You may want to point out that practitioner time is limited, or that missed appointments may be subject to a "missed appointment fee." Make it clear that your practice has "set aside this time specifically for you," and that you in turn expect the patient to make it a priority to keep the appointment.

Let us know if this article was helpful -- write us at editor@practicemanagementnews.com.

Links

You can read the entire study from the The Annals of Family Medicine here: http://annfammed.org/cgi/content/full/2/6/541.

These previous articles from Practice Management News may also be of interest:
7 Ways to Reduce No-Shows and Cancellations

PASS IT ON: Know anyone who might be interested in this newsletter?
Forward this page to your friends.